2008/2009 REGISTRATION FORM - Sooke Dance Studio (Carole Cave Dance)

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Participant's Name _____________________________________

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Address _____________________________________

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___________________________________________

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_____New postal code_____________________________________

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Telephone # (day/cell) _______________________ (eve)____________________________

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Email address______________________________________________

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Parent's name_________________________________________

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Child's Age _______ Birthdate__________________________

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Emergency Contact (Name and Phone Number) _________________________________________

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Programs (Check appropriate boxes and add details)
                                          class:                                                         day/time:

Preschool                    ___________________________        _____________________________
                                         _________________________       __________________________
Youth                           ________________________        __________________________
                                          ________________________        __________________________
                                 ________________________        __________________________

Teen                            ________________________        __________________________                                            ________________________        __________________________
                                 ________________________         __________________________
Adult                           _________________________       __________________________ 
                                 _________________________       __________________________
                                         _________________________        __________________________
Special Session          _________________________      ___________________________
Summer Camp           _________________________     ___________________________

               

AGREEMENT Please read and sign below
I authorize Sooke Dance Studio/Carole Cave Dance to use photos of myself/my child for educational or promotional purposes in any type of media, including its website. yes no

WITHDRAW POLICY:
One full MONTH advanced written notice (email acceptable) required for all withdrawal from any class or classes. No partial month fees refunded. NO EXCEPTIONS. No withdrawals will be accepted after March 1. Dance fees are not refundable after March 1.

LIABILITY DISCLAIMER:

The student/parent acknowledges that, as with any physical activity such as dance, there are inherent risks of injury and the student knowingly and voluntarily assumes the risk of injury and agrees that Carole Cave Dance and the/it's instructors are not liable for personal injuries that the student may suffer during class or at any related function. The student further acknowledges that neither Carole Cave Dance nor its instructors are responsible for any loss of or damage to, the student's personal property.

 I agree to the above conditions.

 

Signature__________________________________________

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